Secondary acute myeloid leukaemia (AML)

About secondary AML

AML is a fast-growing blood cancer. It develops when blood-forming cells grow out of control. They can build up in your bone marrow and stop it making enough healthy blood cells.

Often, we don’t know exactly what causes AML. But sometimes it happens as a result of something else. This is secondary AML. It can develop:

• After treatment for a different cancer.
• From another type of blood cancer. This is usually myelodysplastic syndrome (MDS) or a myeloproliferative neoplasm (MPN).

Secondary AML affects fewer than 900 people a year in the UK. It happens because blood cancers and cancer treatments can damage the cells in your bone marrow.

Signs and symptoms of secondary AML

The signs and symptoms of secondary AML include:

• Fatigue
• Infections
• Feeling breathless
• Bruising or bleeding
• Fever
• Bone pain
• Low red blood cell count (anaemia)
• A swollen spleen or liver

Some people might not have any new symptoms. You may be diagnosed after routine tests for your other cancer.

The diagnosis is confirmed using blood tests and bone marrow tests.

Treating secondary AML

Your medical team will recommend treatment based on your needs. This might be intensive or non-intensive treatment.

We have separate information on different treatments. This includes how you have them and possible side effects.

Intensive treatment involves chemotherapy. It is usually a treatment called liposomal daunorubicin + cytarabine. It’s also known as CPX-351 or Vyxeos.

• You have it through a drip into a vein, or a central line if you have one. You usually have it as a hospital outpatient. You have treatment in cycles, with time in between for your bone marrow to recover.
• You may also have a targeted medicine. This depends on the genetic changes in your leukaemia cells.
• Some people might have a stem cell transplant. This is a very intensive form of treatment. It is not suitable for everyone. Your medical team will explain if it’s an option for you.

Sometimes your team might recommend a different type of chemotherapy. They will explain what treatment they recommend, where you will have it, and what you can expect from it. For some treatments, you may need to stay in hospital.

Non-intensive treatment is gentler. It aims to control your AML as much as possible. But it does not cure it. It usually involves low-dose chemotherapy or targeted treatment to take at home.

Secondary AML can be difficult to treat. Outcomes vary from person to person. Your medical team are best placed to discuss what they expect for you.

It can be hard dealing with treatment and its side effects. Don’t be afraid to ask for help from family, friends, your medical team or Leukaemia Care.